ADHD and impulsive behaviour

Attention-deficit hyperactivity disorder (ADHD) is the most diagnosed behavioural disorder in children. The development of ADHD is multifactorial and can involve genetic, social, nutritional, parental and developmental factors, as well as environmental toxins. It is normal for children to have periods of inattention, impulsiveness and hyperactivity.However, when these behaviours become more frequent, last longer and more severe, it can affect optimal development. When ADHD goes unrecognised it can often result in underperformance at school, potentially placing a large strain on school and family relationships. The main sub-types of ADHD include: predominately inattentive, predominately hyperactive-impulsive and combined hyperactive-impulsive and inattentive.1 For the diagnosis of ADHD to occur, a child must have symptoms for at least six months and the symptoms need to be more frequent and more severe when compared to children of the same age.

General conventional treatment involves stimulant and antidepressant medications combined with behavioural interventions. Methylphenidate is a commonly prescribed stimulant medication – its main action is to mimic dopamine and norepinephrine. Interestingly, 20-30% of children do not respond to the drug class and/or are unable to tolerate them. The most frequent adverse events include anxiety, mood swings, loss of appetite, insomnia, increases in blood pressure and heart rate and, with larger dosages, can cause paranoid psychoses.

As ADHD may be due to an underlying nutritional deficiency, it has led to multiple investigations into nutrients and the role they play. One study evaluated the role of a soy-derived phosphatidylserine and its use in reducing ADHD symptoms in children. Phosphatidylserine is a naturally occurring phospholipid, found in the largest concentrations in organs with high metabolic activity such as the brain, lungs, heart, liver and skeletal muscle. Phosphatidylserine has a therapeutic role on various neurotransmitters including acetylcholine, dopamine, serotonin and norepinephrine. The above-mentioned study cited a randomised, double-blind placebo controlled clinical trial that evaluated 36 children with ADHD, aged 4-14 years, and who had not previously been medicated. The treatment involved dosing with 200mg of soy-derived phosphatidylserine for 2 months. To measure the outcomes of inattention, hyperactivity and impulsivity, the ADHD diagnostic criteria of the American Psychiatric Association, DSM-IV-TR was used and short-term auditory memory and working memory were assessed using the Digit Span Test of the Wechsler Intelligence Scale for Children.

The results highlight that supplementing with phosphatidylserine significantly improved (P < 0.05) inattention and revealed an improvement in the children’s classroom behaviour and social skills, such as less walking around in the classroom or talking during class, as well as significant improvements in short-term auditory memory.

Phosphatidylserine is just one of the many nutrients that affect behaviour and neurological health.